Radical Nephrectomy

What is a Nephrectomy?

The kidneys are major organs located at the back of your abdomen, responsible for filtering blood and removing waste from your body in the form of urine.

Kidney diseases such as cancer can cause serious impairment to the kidneys functions.

Laparoscopic nephrectomy is a minimally invasive procedure that involves the removal of a diseased kidney. Laparoscopic nephrectomy is a safe and effective alternative to conventional open surgery.


Types of Radical Nephrectomy?

There are three common approaches for a Radical Nephrectomy, these are

  • Open Radical Nephrectomy (often employed in locally advanced tumour with vena cava involvement)
  • Laparoscopic Radical Nephrectomy
  • Robotic Radical Nephrectomy


Locally Advanced Kidney Tumour with IVC (Inferior Vena Cava) Involvement

Indications for Nephrectomy

  • Kidney cancer
  • Kidney stones that have caused extensive damage to the kidney tissues
  • Chronic infection that causes scarring and loss of kidney function
  • Removal of donor kidney for transplantation
  • Benign kidney diseases such as polycystic kidney disease (cluster of cysts in the kidney), symptomatic hydronephrosis (swollen kidney due to urine retention) and shrunken kidney
  • Control of life threatening bleeding in case of major trauma to the kidney


Benefits of Laparoscopic radical Nephrectomy

This surgical approach offers a number of benefits, chief among them are:

  • smaller incisions which are minimally invasive (Favourable cosmetic result)
  • less bleeding, and pain
  • quicker recovery times and reduced hospital stay
  • reduced incidences of postoperative complications.


Surgical Procedure

A laparoscopic nephrectomy procedure follows the steps below:

  • Dr Kim will make small incisions on your abdomen to insert a thin tube with a small video camera attached to it and other surgical tools.
  • The ureter and blood vessels that carry blood to and from the kidney to be removed are clipped.
  • The kidney is then released carefully from the surrounding tissues and enclosed in a bag within the body.
  • This is removed by enlarging one of the incisions.
  • The incisions are closed firmly with stitches.

The complete procedure may take 2-3 hours and is performed under general anaesthesia.


Post-Operative Procedure

You will be encouraged to have some fluids immediately after the surgery.

The intravenous fluids will be stopped the day after the operation and you will be advised to gradually increase your food intake. You may feel nauseous and experience mild pain in your shoulder and abdomen.

You will have a urinary catheter inserted to make it easier to pass urine. The nurse may measure the amount of urine you have passed. The wound dressing may be removed after 48 hours and you will be advised to walk short distances and gradually advance to longer durations.

You will be advised to avoid heavy lifting and drink plenty of water so you can pass urine regularly. You can resume your daily activities gradually after 2-3 weeks.


Risks and Complications

The laparoscopic nephrectomy may involve certain risks and complications. They include:

  • Wound infection
  • Pulmonary embolism (blood clot in the leg or lung)
  • Shoulder pain and abdominal bloating (due to carbon dioxide insufflation – will resolve within 24 hours)
  • Urine infection
  • Chest infection
  • Bleeding
  • Injury to neighbouring tissues